title: Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis.
abstract: OBJECTIVE
  To investigate the effects of Merogel coverage on ostial patency in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for primary chronic dacryocystitis (PCD).
  
  
  METHODS
  In all, 260 patients with unilateral PCD were randomized into two groups: the Merogel group and the control group. All patients underwent EES-DCR. The Merogel group received Merogel covering the wound 1-2 mm around the ostium and the control group received no treatment. Patients were followed up for 9 months. The mucosal epithelialization of the wound, the proliferation of fibrosis tissue, and the success rate of ostial patency were compared.
  
  
  RESULTS
  Our study included 112 patients in the Merogel group and 115 patients in the control group. At the 2-week review, intact mucosal epithelium lined the ostia in 96 Merogel patients compared with 80 control patients (ITT analysis: χ(2)=4.502, P=0.034). At the 9-month review, scars were present in 18 patients in the Merogel group compared with 39 patients in the control group (ITT analysis: χ(2)=9.909, P=0.002, ITT analysis). No differences were observed in the granulation formation between the two groups. The success rate of ostial patency reached 94.6% (106/112) in the Merogel group compared with 80% (92/115) in the control group (ITT analysis: χ(2)=4.151, P=0.042).
  
  
  CONCLUSIONS
  Merogel coverage may enhance the success rate of EES-DCR for PCD by promoting mucosal epithelial healing and preventing excessive scarring.
authors.affiliation: Department of Orbital and Oculoplasty Surgery, Eye Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, PR China. wuwencan118@163.com
authors.forename: W
authors.initials: W
authors.lastname: Wu
authors.forename: P S
authors.initials: PS
authors.lastname: Cannon
authors.forename: W
authors.initials: W
authors.lastname: Yan
authors.forename: Y
authors.initials: Y
authors.lastname: Tu
authors.forename: D
authors.initials: D
authors.lastname: Selva
authors.forename: J
authors.initials: J
authors.lastname: Qu
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003607:Dacryocystitis / Q000188:drug therapy* / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy; D004848:Epithelium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008795:Metronidazole / Q000493:pharmacokinetics / Q000494:pharmacology*; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D008795:Metronidazole; D006820:Hyaluronic Acid